Plaque-causing bacteria can ‘jailbreak’ from the mouth into the bloodstream and increase your risk of heart attack and stroke, according to research from the University of Bristol.

In September, 2010, Professor Howard Jenkinson, spoke at the Society for General Microbiology’s autumn meeting in Nottingham, England. He explained how oral bacteria can wreak havoc if they are not kept in check by regular brushing and flossing. “Poor dental hygiene can lead to bleeding gums, providing bacteria with an escape route into the bloodstream, where they can initiate blood clots leading to heart disease,” he said. In periodontal disease, the inner lining of the gum is susceptible to bleeding and provides an entry point for the bacteria and the ‘jailbreak’.

Streptococcus and many other bacteria commonly live in the mouth, confined within communities termed biofilms or plaque and are responsible for causing tooth decay and gum (periodontal) disease. The University of Bristol researchers showed that once let loose in the bloodstream, Streptococcus bacteria use a protein on their surface, called PadA, as a weapon to force platelets in the blood to bind together and form clots.

Inducing blood clots is a selfish trick used by bacteria, Professor Jenkinson said: “When the platelets clump together they completely encase the bacteria. This provides a protective cover not only from the immune system, but also from antibiotics that might be used to treat infection. Unfortunately, as well as helping out the bacteria, platelet clumping can cause small blood clots, growths on the heart valves (endocarditis) or inflammation of blood vessels that can block the blood supply to the heart and brain.” Blocked blood vessels are the cause of heart attacks and strokes.

Professor Jenkinson said the research highlights a very important public health message. “People need to be aware that as well as keeping a check on their diet, blood pressure, cholesterol and fitness levels, they also need to maintain good dental hygiene to minimize their risk of heart problems.”

This new research was followed up in October 2010, by researchers from Cornell University and the University of Gothenburg, Sweden who published their findings in the Proceedings of the National Academy of Science. They studied arthrosclerosis, a fatty material called plaque, which collects along the walls of the arteries where it thickens and hardens forming calcium deposits, which may eventually block the arteries.

“Our survey shows that bacteria are pretty good at getting out of the mouth and gut and into the blood stream,” said Ruth Ley, Cornell University assistant professor of microbiology and a senior author of the study with Frederik Bäckhed, a cardiovascular researcher from the University of Gothenburg.

Their findings show that such bacteria as Veillonella and Streptococcus were the most abundant microbiota found in plaque. Furthermore, when a large amount of these two types of bacteria were found in the mouth, the researchers found a corresponding abundance of the same bacteria in the arterial plaque.

Ley and colleagues found a positive correlation between amounts of bacteria and leukocytes (white blood cells) in arterial plaque, supporting the theory that higher levels of arterial plaque lead to an immune response and inflammation.

How do we keep the levels of bacteria, particularly the Streptococcus bacteria at a safe level in the mouth? There needs to be a team approach between the dental professional and the patient. Daily, at home oral hygiene to remove the biofilm from every surface of every tooth including the surfaces under the gum is the first step. This is best accomplished with daily brushing and flossing. Ultrasonic toothbrushes are very effective at removing plaque. Flossing is the most effective way to clean the root under the gum. Other tools can be helpful.

Once the biofilm or plaque becomes hardened on the surface of the tooth it is necessary to have it removed by the dental hygienist. A thorough periodontal evaluation measuring for deeper areas under the gum called ‘pockets’ and assessing bleeding is important to determine and monitor the level of health. When pockets develop, it is important to have scaling and root planing, to remove the colonies of bacteria from the roots. Other periodontal treatments may be indicated.

Today, lasers are being used to treat pockets and are very effective at killing bacteria and treating the inflamed gum with much less post operative pain than traditional periodontal surgery. Many patients who do not brush thoroughly at the gum line will experience no bleeding yet under the gum a painless silent battle exists between your immune system and the bacteria living on the side of the tooth. The body responds with an inflammatory response that can lead to the environment ripe for the ‘jailbreak bacteria’ to enter the bloodstream.

Xylitol, an underutilized natural sweetener renders the Streptococcus bacteria useless. It can no longer secrete the sticky matrix of plaque or replicate. A therapeutic regime of Xylitol can change the ecology of the mouth to a much healthier state. To learn more about Xylitol visit DoctorXylitol.com or SmileDesignCenter.us. 321 751 7775